Adult Protective Services Handbook Revision September 2011
This revision of the Adult Protective Services Handbook was published on September 1 2011. Summaries of new or revised items are provided below.
APS Policy Changes Mandated by Senate Bill (SB) 221, 82nd Legislature
This is the third policy release for FY 2011. The release contains a number of small edits to the sections that address investigation, service delivery, and purchased client services. The changes are designed to provide clarification in each of these areas in order to address requests from external stakeholders, quality assurance, and regional staff.
When a Client Withdraws From Services
The supervisor has the discretion to waive the requirement for multiple home visits after a client withdraws from services if the client has indicated that he or she does not want APS services and the supervisor believes, based on the specialist's observations, that the client may feel harassed by continued APS visits.
Duplicate Referral on Closed Case
The closure code Duplicate Referral/Already Investigated may be used after the original intake has already been closed.
Procedures to Follow When Seeking Entrance Into a Client's Home
Based on the Gates Decision, the steps that a specialist must take when entrance into a client’s home is denied or revoked are provided.
Desk Review of an Investigation
Regional staff may use discretion and wait 30 calendar days instead of 20 to receive a request for a desk review from the perpetrator after the official notice is mailed by DFPS. Program administrators may conduct an initial review of an investigation as soon as the request is received.
Notification to Law Enforcement
Notification to law enforcement is not required if law enforcement was the reporter.
Disposition of Valid/No Fault
APS specialists use the disposition Valid,/No Fault if a perpetrator was a mental illness or an intellectual disability.
APS specialists may use Valid/No Fault for neglect allegations involving family guardians, but not contracted or professional guardians.
Use of the Alternative Resources Checkbox
APS specialists mark the Alternative Resources checkbox in IMPACT before using Purchased Client Services.
Discovery That a Client Has a Guardian
If the specialist does not discover that the client has a guardian until the service delivery stage of the case he or she must still notify the court of the investigation.
Transferring Cases
Policy is clarified regarding transferring cases during the investigation or service delivery stages.
Initial Face-to-Face Contact Is Unsuccessful
If the locating information for client is known to be correct after the second attempted face-to-face contact, the APS specialist follows the procedures in 2261 Procedure When Client Refuses to Cooperate With the Investigation.
Demonstrating Scale During Photography
It is best practice to hold or request that the client hold a ruler or an object of known size (such as a dollar bill) against the injury as a point of reference to show the size of the injury.
Signing Release Forms on the Tablet
Written statements, release forms, and diagrams may be obtained using a hard copy of the document or electronically using the tablet PC.
Time Frame for Initiation Expires
Specialists must consult with their supervisor before the 24-hour initiation time frame expires when an initiation contact has been unsuccessful.
Definitions for the Action and Outcome Options in the Outcome Matrix
An appendix that has a chart to provide general definitions for the action and outcome options in the outcome matrix has been added.
When Exploitation Is Invalid, but Neglect Is Found
The specialist validates neglect if exploitation is invalid, but the client is in a state of caretaker neglect or self-neglect.
Purchase Order for Placement Services (POPS)
Procedures for use of POPS are provided when an APS specialist arranges conditional payment for nursing home care when the client cannot pay.
Documentation by the Secondary Specialist
The secondary APS specialist enters all appropriate documentation in the IMPACT system and documents his or her name as the person making the entry.
Program Name Change
APS MH&MR Investigations has been changed to APS Facility Investigations.
Items Included in This Release
The following items are revised, added, renumbered, or retitled.
APS Policy Changes Mandated by Senate Bill (SB) 221, 82nd Legislature
The SB 221 legislative changes affect APS policy as of 9/1/2011. The bill:
• expands the list of persons who may receive disclosure of criminal history information;
• states that APS does not have to notify law enforcement at point of intake if law enforcement reported the alleged abuse, neglect, or exploitation to DFPS;
• clarifies that term protective services does not include conducting an investigation regarding alleged abuse, neglect, or exploitation of a person age 65 or older or an adult with a disability.
• states that APS may furnish services to a relative or caretaker of an APS client if services are necessary to prevent the client from further abuse, neglect, or exploitation; and
• extends the time an emergency order for protective services is valid.
See:
2270 Referring Cases to Law Enforcement
2271 Procedure for Referrals to Law Enforcement
2430 Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services During an Investigation
3110 Determining Eligibility for Services
3130 Providing Services Regardless of the Client’s Financial Resources
3510 Description of Purchased Client Services
3522 Developing a Service Plan When Using Purchased Client Services (PCS)
3523 Authorizing Purchased Services
3525 Obtaining Management Approval to Authorize Purchased Client Services (PCS) for the Client, Family Members, or Caretaker
4500 Emergency Order for Protective Services (EOPS)
4530 Termination or Expiration of a Court Order for Emergency Protective Services
4540 Extension of a Court Order for Emergency Protective Services
Items Included in This Release
The following items are revised, added, renumbered, or retitled.
1210 Interpreter Services for Principals With Limited English Proficiency (LEP) or Impaired Sensory or Speaking Ability
1211 Procedure for Providing Interpreter Services
1213 Procedure for Accommodations for Hearing Impairments
1215 Documentation for LEP or Sensory or Speaking Impairments
1311 Procedure for Eligibility Criteria
1348 Exploitation (EXPL) Allegations
1348.1 Procedure for Assessing Exploitation (EXPL) Allegations
1431 Procedure for Assessing State Mental Health and Mental Retardation Services Allegations
1432 Home and Community Based Services (HCS) Investigations Allegations
1530 Procedure for Complaints That Do Not Allege Abuse, Neglect, or Exploitation
1540 Allegations Involving Texas Department of Aging and Disability Services (DADS)
1541 Allegations in Facilities That Are Licensed or Unlicensed but Subject to Licensure by DADS Regulatory Services
1560 Allegations Involving the Texas Department of State Health Services (DSHS)
2141 Procedure for Assigning Secondary APS Specialists
2142 Documentation for Secondary APS Specialists
2210 Determining Appropriate Contacts for Case Initiation
2212 Procedure When Initiation Cannot Be Completed in 24 Hours
2251 Procedure for When a Client Is Not Located at Initial Face-to-Face Attempt
2261 Procedure When Client Refuses to Cooperate With APS Investigation
2261.1 Procedure for Choosing a Disposition When a Client Has Refused to Cooperate With the APS Investigation
2270 Referring Cases to Law Enforcement
2271 Procedure for Referrals to Law Enforcement
2334.1 Procedures for Written Statements
2334.2 Ensuring the Integrity and Security of Documents Obtained Using the Tablet PC
2341 Interviewing Clients
2341.1 Procedures for Interviewing Clients
2341.11 Denial or Revocation of Permission to Enter
2341.12 Transporting a Client for an Interview
2341.13 Conducting the Interview With a Client
2345 Interviewing Medical or Mental Health Staff
2351 Procedure for Taking Photographs
2351.1 Sensitive Photography
2351.2 Photographing Living Environments
2363.2 Documentation for Drawings and Diagrams for Evidence
2381 Criminal History Records Checks
2381.1 Required Criminal History Records Checks
2381.2 Optional Criminal History Records Checks
2381.3 Criminal History Records Checks From Sources Other Than DPS
2381.4 Available Information Is Insufficient for Criminal History Records Checks
2381.5 Criminal History Records Checks and Referrals to DADS Guardianship Services
2381.6 Procedure for Obtaining Criminal History Information
2381.7 Using Criminal History Information to Reach a Finding
2430 Assessing Indicators of a Lack of Capacity to Consent to or Refuse Protective Services During an Investigation
2510 Monthly Status Contacts (MSCs) During Investigations
2511 Procedure for Monthly Status Contacts (MSCs) During Investigations
2511.1 Exceptions for Monthly Status Contacts (MSCs) During Investigations
2511.11 MSCs and the Month of the Initial Face-To-Face Contact
2511.12 MSCs and the Month of Closure in the Investigation
2511.13 MSCs When the Client Cannot Be Located During the Investigation
2511.14 MSC When the Client Refuses to Cooperate
2511.15 MSC When the Client Dies During the Investigation
2530 Subject Matter Expert (SME)
2531 Procedure for SME Consults
2531.1 Documentation for SME Consults
2540 Additional Allegations Received During the Investigation Stage
2541 Procedure for Additional Allegations Received During the Investigation Stage
2550 Client Moves or Cannot Be Located Before the Investigation Is Complete
2551 Procedure for When a Client Cannot Be Located
2551.1 Procedure for Using DFPS Person Locator Services
2552 Procedure Used When a Client Moves Within Texas
2553 Procedure Used When a Client Moves Out of Texas
2663.1 Procedure for Gaining Access to the Ward During an Investigation
2673 Procedure for Providing Emergency Client Services During an APS Facility Investigation in an HCS Program
2683 Investigations Involving Nursing Home Residents
2683.1 Procedure for Investigations Involving Allegations of Exploitation or Eviction
2692 Procedure for Exploitation Allegations Involving HCSSA Employees
2692.1 Exploitation and Failure to Provide Services
2692.2 Client Makes a Loan to HCSSA Employee or Privately Paid Caregiver
2692.3 Exploitation and Medicaid Fraud
2710 Allegation Disposition
2711 Procedure for Determining Allegation Validity
2711.1 Factors Weighed in Determining Caregiver Neglect
2711.2 Factors Weighed in Determining Self-Neglect
2711.3 Factors Weighed in Determining Abuse
2711.4 Factors Weighed in Determining Exploitation
2711.5 Factors Weighed in Determining Suicidal Threat
2821.1 Rapid Closure Codes and Disposition of Other
2821.11 Moved/Unable to Locate
2821.12 Administrative Closure
2821.13 Does Not Meet Definition of APS
2821.14 Client Died
2821.15 Duplicate Referral/Already Investigated
2821.16 Reclassification
2821.17 Other Agency or Out of State
3110 Determining Eligibility for Services
3130 Providing Services Regardless of the Person’s Financial Resources
3218 Making a Reasonable Effort
3230 Procedure for Additional Allegations Received During the Service Delivery Stage
3231 Procedure for New Intake Report Following Additional Allegations
3251 Monthly Status Contacts (MSCs) During Service Delivery
3251.1 Exceptions for Monthly Status Contacts (MSCs) During Service Delivery
3251.11 MSCs and the Month of Closure During Service Delivery
3251.12 MSCs When the Client Cannot Be Located During Service Delivery
3251.13 MSC When the Client Dies During Service Delivery
3251.14 MSCs in Cases Involving DADS Guardianship Services
3252.1 Documentation of Unsuccessful Attempts at Monthly Status Contacts
3471 Procedure for Case Closure During Service Delivery
3473 Client Withdraws From Services
3474.1 Procedures to Follow When a Client Dies During Service Delivery
3474.11 Procedure for New Intake Received Before Client’s Death in Service Delivery
3510 Description of Purchased Client Services
3522 Developing a Service Plan When Using Purchased Client Services (PCS)
3523 Authorizing Purchased Services
3525 Obtaining Management Approval to Authorize Purchased Client Services (PCS) for the Client, Family Members, or Caretaker
3527 Specific Purchases Using Purchased Client Services
3527.1 Providing Purchased Client Services in Home- and Community-Based Services (HCS) Programs
3527.2 Storage Unit Fees
3527.21 Procedure for Payment of Storage Unit Fees
3527.3 Applied Income Payment in Nursing Homes
3527.31 Procedure for Payment of Applied Income
3527.4 Eviction of Alleged Perpetrator
3527.41 Procedure for Payment of Eviction of an Alleged Perpetrator
3527.42 Documenting Payment and Client Initiation of Eviction of an Alleged Perpetrator
3530 Documenting Purchased Client Services
3610 State Term Contract Procurement Cards
3641 Procedure for Claims Processing
4111 Filing Fees for Eviction of Alleged Perpetrator
4130 Documentation of Legal Actions
4131 Documentation of the Guardianship Detail Page
4140 Consultation With Regional Attorneys
4500 Emergency Order for Protective Services (EOPS)
4520 Authorization for Emergency Protective Services Before a Court Order Can Be Obtained
4521 Requesting Emergency Assistance Without a Court Order
4522 Terminating Emergency Services on the Next Business Day
4523 Notifying the Regional Attorney of the Client’s Death
4530 Termination or Expiration of a Court Order for Emergency Protective Services
4540 Extension of a Court Order for Emergency Protective Services
4783.4 Procedure for Case Management After Emergency Referral Form Is Submitted to DADS
5112.1 Individuals and Entities Entitled to the Case Record
5112.13 Release of APS In-Home Case Records to Facilities or Providers Under APS Facility Jurisdiction
5113 Disclosure of Case Information to Other Entities to Assist Clients to Obtain Services
5116 Disclosure of Criminal History Information
5118.2 Notification of Investigation Involving a Guardianship to Probate Court
5118.21 Notifying the Probate Court When DADS Is Guardian or Has Pending Guardianship
5118.22 Notifying the Probate Court When the Alleged Perpetrator Has a Guardian
5118.23 Notifying the Probate Court When Exploitation Allegations Involve a Guardian of the Estate
5118.24 Notifying the Probate Court in Cases Involving an Administrative Desk Review
5120 Release of Case Information to Entities Responsible for Protection of Clients
5241 When to Merge Cases
5241.1 Merge Only Open Cases in the Same Stage
5241.2 Close Duplicate Reports Without Merging Cases
5300 Administrative Desk Review for Designated Perpetrators
5320 Notifying the Designated Perpetrator of Findings and Eligibility for Review
5321 Timely Request for an Administrative Desk Review
5321.1 Request for Records for an Administrative Desk Review
5330 Procedure for the Administrative Desk Review for Designated Perpetrators
5331 Time Frame for Conducting the Administrative Desk Review
5332 Notification of Delay of the Administrative Desk Review
5333 Completing and Documenting the Administrative Desk Review
5334 Closing a Case in Service Delivery Following an Administrative Desk Review
5335 Notification of Results of the Administrative Desk Review for Designated Perpetrators
5336 Circumstances in Which Findings May Be Released (Release Hearing)
5422 Administrative Review in Non-EMR Cases
5423.1 Receipt or Non-Receipt of Request for a Release Hearing in Non-EMR Cases
5424.2 Release of Findings in Non-EMR Cases
5424.22 Release of Findings on Investigations of Foster Home Providers and Employees
5424.4 Release of APS Findings to Professional Licensing Boards, Commissions, and Other Agencies
5424.45 Release of APS Findings to Guardianship Certification Board
Appendix IX: APS Service Codes, Descriptions, Unit Types, and Descriptions
Appendix XVI: Using the Tablet PC for Obtaining and Storing Written Statements and Diagrams
Cross-references to revised items have been updated in:
1430 Assessing State Mental Health and Mental Retardation Services Allegations
1431 Procedure for Assessing State Mental Health and Mental Retardation Services Allegations
1432 Home and Community Based Services Waiver (HCSW) Investigations Allegations
2200 Case Initiation
2672.2 Circumstances That Require APS In-Home Investigation
2673 Procedure for Providing Emergency Client Services During an MH and MR Investigation in an HCSW Program
3215.4 Example of the Outcome Matrix Detail
3253 Procedure for Monthly Status Contacts in the Month of Closure
3527 Providing Purchased Client Services in Home- and Community-Based Services Waiver (HCSW) Programs
3353 When Services Are Not Available for Community-Based Long-Term Care
3354 Resolution When a Client Rejects Alternative Services
3353 When Services Are Not Available for Community-Based Long-Term Care
3355 Using Purchased Client Services (PCS) for Personal Attendant Care
3470 Case Closure During Service Delivery
3471.1 Supervisory Review of Closure
3523 Authorizing Purchased Client Services
3535 APS Service Authorization
3611 Procedures for the Use of State Term Contract Procurement Cards
3622 Determining Rate for POPS
4732.1 Criminal History Checks
5119.1 Release of Information on Adult Foster Care Provider Applicants (DADS Form 2357, DFPS Records Check)
5120 Release of Case Information to Entities Responsible for Protection of Clients
5431 Sending Notice of Intent to Release in Client Protection Cases